discussion regarding education of NP (DNP) and PA compared to MD/DO

wowza · Feb 24, 2010

This is an RN to DNP curriculum from MGH Adult Primary Care.
http://www.mghihp.edu/academics/nursing/degree-options/rn-to-doctor-of-nursing-practice/curriculum/adult-primary-care.aspx
Clinically related coures (35- 43 credits)
2 Credits Advanced Pathophysiology3 Credits Advanced Pharmacology
4 Credits Adv Assess/Diag Reas - Adult
3 Credits Chld/Adol Psych Mental Hlth
5 Credits DNP Residency
3 Credits Nsg Mngmt/Adlt: Prim Care I Th
3 Credits Nsg Mngt Adlt: Prim Care II Th
3 Credits Nsg Mgmt Adlt: PC III Theory
3-6 Credits Nsg Mgt Adlt:Prim Care I Clin
3-6 Credits Nsg Mgt of Adlt:PC II Clinical
3-6 Credits NU Mgmt Adlt: PC III Pract
Non-clinical fluff (33-43 credits)
3 Credits Hlth Care Policy & Politics
3 Credits Leadership for Adv. Nu Pract.
2 Credits Professional Issues
3 Credits Population Health
3 Credits Outcomes measurement3 Credits Survey of Health Care Informatics
2-3 Credits Designing Clin Rsrch
3 Credits Knowledge & Inq Dev for NP
3 Credits NU Research, Analysis & Crit
3 Credits Mentored doctoral practicum
3 Credits Intermediate biostatsitics
2 Credits Capstone project

My medical school's curriculum

First 2 years:

Clinically related 99.5 credits

Medical Genetics 3.5 credits

Anatomy 10.5 credits

Physiology 9 credits

Histology 3 credits

Immunology 3 credits

Behavioral sciences 1 credit

Neuroanatomy- 7 credits

Foundations of clinical medicine 14 credits

Geriatrics 1 credit

Overview of Microbiology 6 credits (more in each organ system)

Overview of Pharm 6 credits (most in each organsystem)

Intro to pathogenesis- 1 credit (almost all path is in the organ systems)

Systems: takes pathophys, pharm and micro involved in the organ system

Heme/onc 3.5 credits

Endocrine 3 credits

Renal - 3.5 credits

Resp- 3.5 credits

Cardio 5 credits

Behavioral/psych- 3 credits

Neurology- 3 credits

Women's health/OB- 4 credits

GI- 3 credits

MSK/ortho- 3 credits

Less clinically related 12.5 credits

Pop med (statisitcs, etc) 2.5 credits

Biochemistry- 7 credits

Ethics 3 credits

Clinical Hours for which you do not get "credits"

Pediatrics 600 hours

Surgery 650 hours

Neurology 200 hours

Family med 200 hours

OB/GYN- 400 hours

Pysch- 300 hours

IM- 720 hours

ICU- 250 hours

Medicine 2- 300 hours

Electives (min allowed) 640 hours

Total 3rd year clinicals (not including most of 4th year electives) : 4250 hours of clinicals

So comparing that is ~100 credits for clinically related things in Med school while only 40 in DNP school, some of which are double counted because 20 of those credits are your clinical hours.

wowza · Feb 24, 2010

The difference between the 2 is astounding.

prairienp · Feb 24, 2010

the difference between the 2 is astounding.

yes, the programs of study are different, no argument. the intent of the discussion is regarding education of providers. didn't see the thread asking pas and mds to bash np programs of study. if you have the need to show how superior you are in all of these ways i know your comments will be welcome on other forums. in fact, you can simply cut and paste and receive numerous kudos. one thing is clear, the tolerance level of allnurses is quite high to continue a thread with so many hostile comments towards nps. i am sure that if you were to post on other sites and change np to md or pa you would be banned or the thread locked quickly. my point is, np education includes communication and tolerance of others (fluff courses). in a very strange way the continued hostile comments and tearing down of the np curriculum has in fact demonstrated the value of our education. we are here to help clients, who are active participants in their health care not to control the process. we are seeking the ability to provide care not control health care.

PICUPNP · Feb 24, 2010

What hostile comments? I'm an Np and totally support what wowza an the others are saying. NPs DO NOT HAVE AN EDUCATION EQUIVALENT TO DRS OR PAs. NP education doesn't compare to either PA or MD/DO. How many times do the curriculums need to be posted before someone can see that they are not the same? I went through and NP program and currently practice, and I wish I had the same education that the PAs receive. The "fluff" classes in the Np programs are just that, fluff. They need to be replaced with the hard sciences and the theory BS cut completely. These are programs built to prepare NPs for pracitice, not hand holding.

prairienp · Feb 24, 2010

what hostile comments? i'm an np and totally support what wowza an the others are saying. nps do not have an education equivalent to drs or pas. np education doesn't compare to either pa or md/do. how many times do the curriculums need to be posted before someone can see that they are not the same? i went through and np program and currently practice, and i wish i had the same education that the pas receive. the "fluff" classes in the np programs are just that, fluff. they need to be replaced with the hard sciences and the theory bs cut completely. these are programs built to prepare nps for pracitice, not hand holding.

hostile

adj.

1. of, relating to, or characteristic of an enemy: [color=#226699]hostile forces; hostile acts.

2. feeling or showing enmity or ill will; antagonistic: [color=#226699]a hostile remark.

3. unfavorable to health or well-being; inhospitable or adverse: [color=#226699]a hostile climate.

n. 1. an antagonistic person or thing.

who is saying they have an educational equivalent ? i agree they are not the same. i have supported your desire to return to pa school in the past, i think you would be a great pa. you would be happier, please take the opportunity and become a pa. too bad the requirements changed; 25 years ago you could have taken the pance and been a pa with your np training.

i am sure you enjoyed the recent study discussed on national news about touch (hand holding) by healthcare providers and waitresses. touch resulted in better outcomes by patients and higher tips for waitresses.

springing · Feb 24, 2010

Whoah, I missed that the first go around... PA training is inferior? What do you use to claim that? I think you ought to check your curriculum against ours. Now I'll admit, we don't have all those fancy patient satisfaction courses and communications classes and we also don't have 4 years of experience opening tylenol bottles and giving suppositories, but I think we more than make up for that with our extra training in pathology, pharmacology, differential diagnosis, and clinical work measured by thousands not hundreds.

As much as I was enjoying this debate, I am for sure done with it because it's SO one-sided in terms of fact and logic...and you know whose side I'm on. But I want to weigh in on this. I'm not a PA, but I do know that PAs ARE mostly independent of MDs. In most states PAs can open up their own primary care clinics and operate without an MD on board. "MD supervision" equates to meeting with an MD once every few months. On another forum there's a PA who posts regularly who runs an entire emergency department by himself at night while the MD sleeps at home.

I also don't believe that PA training is inferior. That's laughable because PAs can switch specialties and NPs can't. Why can PAs switch? Because their training prepares them for every field of medicine as a midlevel. NP training prepares them for one thing, and if they want to switch, they have to complete a whole new year of education, which will contain the clinical hours the PA already had in their original two/three years of education.

What I don't understand is why the NPs WANT it like this. I just don't get it. I know a lot of people don't actually support the DNP and resent a whole year of management and fluff (padding a nursing dean's pockets!) but the core MSN curriculum is so fluffy too, and it does hold NPs back because if they want to switch they have to go back to school again (and pad a nursing dean's pockets...) why continually insist your education is superior when it holds you back from being as mobile as the PA?

Trauma Columnist · Feb 25, 2010

We enjoy lively debate but will not tolerate rudeness. Please keep things civil.

wowza · Feb 25, 2010

yes, the programs of study are different, no argument. the intent of the discussion is regarding education of providers. didn't see the thread asking pas and mds to bash np programs of study. if you have the need to show how superior you are in all of these ways i know your comments will be welcome on other forums. in fact, you can simply cut and paste and receive numerous kudos. one thing is clear, the tolerance level of allnurses is quite high to continue a thread with so many hostile comments towards nps. i am sure that if you were to post on other sites and change np to md or pa you would be banned or the thread locked quickly. my point is, np education includes communication and tolerance of others (fluff courses). in a very strange way the continued hostile comments and tearing down of the np curriculum has in fact demonstrated the value of our education. we are here to help clients, who are active participants in their health care not to control the process. we are seeking the ability to provide care not control health care.

np (and pa) education is good for what they currently do, but i feel that if the dnps are pushing for equal practice, then at least they could beef up their coursework. comparing the two, the dnp is not very different from the current np that requires a masters- yet costs the extra year of tuition and they had added the title "doctor". based on the lack of change between the programs that you normally see between a masters and a doctorate, i have always felt this was nothing more than a political move especially because the people pushing for complete equal practice rights are the same ones who created the new degree. that really is beside the point though.

i am not saying the statistics, nursing leadership and research classes aren't worthwhile. what i am saying though, is if you are trying for an abreviated course of study, these do not belong in a clinical doctorate because they end up taking the place of other, more important things for patient care.

hostile
i am sure you enjoyed the recent study discussed on national news about touch (hand holding) by healthcare providers and waitresses. touch resulted in better outcomes by patients and higher tips for waitresses.

i tried to google search this article but i must not have the right key words . i'd be interested in reading it.

mbreaz1 · Feb 25, 2010

But WOWZA, if the patient is happy, doesn't that mean I did a good job!??? I don't understand.... You're saying that if I do something wrong, and the patient is happy, I'm still wrong? Are you sure? all my communication classes didn't prepare me to accept this, you must be wrong....
sorry, couldn't resist.

What you all fail to acknowledge is that patients are never happy if you don't provide good care. Those two are definitely mutually exclusive. You can't do a poor job and make a patient happy.

bajasauce07 · Feb 25, 2010

not true. definitely not true. I don't get how you believe that. If you are nice to a diabetic patient who has protenuria on his dipstick, and you never put him on an ACE-I or ARB. A few years later he enters into renal failure that could have been prevented. As long as you are nice to the guy he'll never know the difference and be completely satisfied with you as a provider. After all, I'm sure if this happened it wouldn't be malicious, it would simply be that the provider didn't know, he would explain to the patient that renal failure is a natural part of the life of many diabetics and both would continue on their way. Seriously, the scenarios are endless. Patients do not know about a lot of what we do. How in the world do you compare a happy patient to a healthy patient? they don't equate. Apples to tigers. It's not even in the ballpark. I've run across the same thing in practice, the PCP doesn't have the patient on x medicine that is necessary according to current guidelines and I have to start it in the hospital. The patient still loves their PCP even though the PCP missed something. The patient just didn't know!s:uhoh3:

mbreaz1 · Feb 25, 2010

NP (and PA) education is good for what they currently do, but I feel that if the DNPs are pushing for equal practice, then at least they could beef up their coursework. Comparing the two, the DNP is not very different from the current NP that requires a masters- yet costs the extra year of tuition and they had added the title "doctor". Based on the lack of change between the programs that you normally see between a masters and a doctorate, I have always felt this was nothing more than a political move especially because the people pushing for complete equal practice rights are the same ones who created the new degree. That really is beside the point though.
I am not saying the statistics, nursing leadership and research classes aren't worthwhile. What I am saying though, is if you are trying for an abreviated course of study, these do not belong in a clinical doctorate because they end up taking the place of other, more important things for patient care.
I tried to google search this article but I must not have the right key words . I'd be interested in reading it.

I really don't think there need to be any changes in the current curriculum for nurse practitioners other than to simply make it more uniform across programs. I also would agree that requiring a doctoral degree doesn't add anything in terms of value to nurse practitioners. I think their education and training levels are fine for them to be independent providers within their scope of practice. I think that people in medical professions get very hung up on titles. It is actually worse than politicians are about it. I think it is silly to go around calling yourself doctor or to expect other people to call you that. It is condescending. Titles are antiquated. The healthcare industry needs to get over itself on a lot of antiquated notions.

prairienp · Feb 25, 2010

I tried to google search this article but I must not have the right key words . I'd be interested in reading it.

I didn't read the article, I think I was listening to the NBC nightly news and they mentioned something about touch. They had images of healthcare providers (I think MDs) and a waitresses. They were quoting a recent journal article; I don't recall the journal. At the time the journal sounded like respectable journal, just can't recall the name.